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The goal of my research program is to identify protein and amino acid (building blocks of protein) requirements during key life stages of growth and development, and in disease.

During pregnancy the nutritional state of the mother influences the rapidly growing fetus and affects long-term health. Due to ethical constraints protein requirements during pregnancy is not well studied. With the use of stable isotope tracers, which are completely safe for use in vulnerable populations like pregnant women, my research will measure requirements and trace complex amino acid metabolic pathways in the human body. The focus will be to make dietary protein and amino acid recommendations to improve long-term health for the mother and child.

Undernutrition or malnutrition has been implicated to be the underlying cause of ~50% of all deaths in children in the developing world. My research will examine the impact of childhood malnutrition on protein and amino acid requirements with collaborations between research institutes located in India and BCCHR in Vancouver.

Evaluation of A Concentrated Preterm Formula as a Liquid Human Milk Fortifier in Preterm Babies at Increased Risk of Feed IntoleranceNutrientsAnish Pillai and Susan Albersheim and Julie Matheson and Vikki Lalari and Sylvia Wei and Sheila Innis and Rajavel ElangoDOI: 10.3390/nu1010143310/2018

Metabolic Availability of the Limiting Amino Acids Lysine and Tryptophan in Cooked White African Cornmeal Assessed in Healthy Young Men Using the Indicator Amino Acid Oxidation TechniqueThe Journal of NutritionMahroukh Rafii and Rajavel Elango and Ronald O Ball and Paul B Pencharz and Glenda Courtney-MartinDOI: 10.1093/jn/nxy03905/2018

Lysine Requirements of Healthy Pregnant Women are Higher During Late Stages of Gestation Compared to Early GestationThe Journal of NutritionMagdalene Payne and Trina Stephens and Kenneth Lim and Ronald O Ball and Paul B Pencharz and Rajavel ElangoDOI: 10.1093/jn/nxx03401/2018

Total Sulfur Amino Acid Requirements Are Not Altered in Children with Chronic Renal Insufficiency, but Minimum Methionine Needs Are IncreasedThe Journal of NutritionRajavel Elango and Mohammad A Humayun and Justine M Turner and Mahroukh Rafii and Veronika Langos and Ronald O Ball and Paul B PencharzDOI: 10.3945/jn.116.24430110/2017

The Indicator Amino Acid Oxidation Method with the Use of l-[1- 13 C]Leucine Suggests a Higher than Currently Recommended Protein Requirement in Children with PhenylketonuriaThe Journal of NutritionAbrar Turki and Keiko Ueda and Barbara Cheng and Alette Giezen and Ramona Salvarinova and Sylvia Stockler-Ipsiroglu and Rajavel ElangoDOI: 10.3945/jn.116.24021802/2017

Host conditioning and rejection monitoring in hepatocyte transplantation in humans.Soltys KA and Setoyama K and Tafaleng EN and Soto Gutiérrez A and Fong J and Fukumitsu K and Nishikawa T and Nagaya M and Sada R and Haberman K and Gramignoli R and Dorko K and Tahan V and Dreyzin A and Baskin K and Crowley JJ and Quader MA and Deutsch M and Ashokkumar C and Shneider BLDOI: 10.1016/j.jhep.2016.12.017PubMed: 2802797112/2016

Proposals for Upper Limits of Safe Intake for Arginine and Tryptophan in Young Adults and an Upper Limit of Safe Intake for Leucine in the ElderlyJournal of NutritionL. Cynober and D. M. Bier and M. Kadowaki and S. M. Morris and R. Elango and M. SmrigaDOI: 10.3945/jn.115.22847811/2016

Determination of the safety of leucine supplementation in healthy elderly menAmino AcidsBetina Rasmussen and Erin Gilbert and Abrar Turki and Kenneth Madden and Rajavel ElangoDOI: 10.1007/s00726-016-2241-004/2016

Cardiac Autonomic Function at Baseline and under Stress and Its Relationship to Circulatory Markers of Inflammation in Obese Compared to Nonobese Children: A Pilot StudyHormone Research in PaediatricsBrenden E. Hursh and Mir Sohail Fazeli and Sarah Wang and Elizabeth A. Marchant and Paula Woo and Rajavel Elango and Pascal M. Lavoie and Jean-Pierre Chanoine and Jean-Paul ColletDOI: 10.1159/00044568504/2016

Dietary Protein Requirement of Men >65 Years Old Determined by the Indicator Amino Acid Oxidation Technique Is Higher than the Current Estimated Average RequirementJournal of NutritionM. Rafii and K. Chapman and R. Elango and W. W. Campbell and R. O. Ball and P. B. Pencharz and G. Courtney-MartinDOI: 10.3945/jn.115.22563103/2016

Dietary Protein Requirement of Men >65 Years Old Determined by the Indicator Amino Acid Oxidation Technique Is Higher than the Current Estimated Average Requirement.Rafii M and Chapman K and Elango R and Campbell WW and Ball RO and Pencharz PB and Courtney-Martin GPubMed: 2696217303/2016

Dietary Protein Requirement of Female Adults >65 Years Determined by the Indicator Amino Acid Oxidation Technique Is Higher Than Current RecommendationsJournal of NutritionM. Rafii and K. Chapman and J. Owens and R. Elango and W. W. Campbell and R. O. Ball and P. B. Pencharz and G. Courtney-MartinDOI: 10.3945/jn.114.19751710/2014

Protein Requirements of Healthy Pregnant Women during Early and Late Gestation Are Higher than Current RecommendationsJournal of NutritionT. V. Stephens and M. Payne and R. O. Ball and P. B. Pencharz and R. ElangoDOI: 10.3945/jn.114.19862209/2014

Healthy pregnant women in Canada are consuming more dietary protein at 16- and 36-week gestation than currently recommended by the Dietary Reference Intakes, primarily from dairy food sourcesNutrition ResearchTrina V. Stephens and Hillary Woo and Sheila M. Innis and Rajavel ElangoDOI: 10.1016/j.nutres.2014.07.00107/2014

Assessment of protein requirement in octogenarian women with use of the indicator amino acid oxidation technique.Tang M and McCabe GP and Elango R and Pencharz PB and Ball RO and Campbell WWDOI: 10.3945/ajcn.112.042325PubMed: 2442954004/2014

Assessing Energy Expenditure in Obese Adolescents in a Clinical Setting: Is the Handheld Indirect Calorimeter Valid and Accurate?Canadian Journal of DiabetesPaula P.W. Woo and Gayathri Murthy and Cindy Wong and Jean-Pierre Chanoine and Rajavel ElangoDOI: 10.1016/j.jcjd.2013.08.20510/2013

Splanchnic First Pass Disappearance of Threonine and Lysine Do Not Differ in Healthy Men in the Fed StateJournal of NutritionK. P. Chapman and R. Elango and R. O. Ball and P. B. PencharzDOI: 10.3945/jn.112.16832801/2013

Lysine from Cooked White Rice Consumed by Healthy Young Men Is Highly Metabolically Available When Assessed Using the Indicator Amino Acid Oxidation TechniqueJournal of NutritionI. R. D. Prolla and M. Rafii and G. Courtney-Martin and R. Elango and L. P. da Silva and R. O. Ball and P. B. PencharzDOI: 10.3945/jn.112.16672801/2013

Determination of the tolerable upper intake level of leucine in acute dietary studies in young men.Elango R and Chapman K and Rafii M and Ball RO and Pencharz PBDOI: 10.3945/ajcn.111.024471PubMed: 2295217810/2012

Measurement of homocysteine and related metabolites in human plasma and urine by liquid chromatography electrospray tandem mass spectrometryJournal of Chromatography BMahroukh Rafii and Rajavel Elango and James D. House and Glenda Courtney-Martin and Pauline Darling and Lawrence Fisher and Paul B. PencharzDOI: 10.1016/j.jchromb.2009.05.00210/2009

Indicator Amino Acid Oxidation Is Not Affected by Period of Adaptation to a Wide Range of Lysine Intake in Healthy Young MenJournal of NutritionR. Elango and M. A. Humayun and R. O. Ball and P. B. PencharzDOI: 10.3945/jn.108.10114704/2009

Amino acid requirements in humans: with a special emphasis on the metabolic availability of amino acidsAmino AcidsRajavel Elango and Ronald O. Ball and Paul B. PencharzDOI: 10.1007/s00726-009-0234-y01/2009

An approach to defining the upper safe limits of amino acid intake.Pencharz PB and Elango R and Ball ROPubMed: 1880611410/2008

High-throughput and simultaneous measurement of homocysteine and cysteine in human plasma and urine by liquid chromatography–electrospray tandem mass spectrometryAnalytical BiochemistryMahroukh Rafii and Rajavel Elango and Glenda Courtney-Martin and James D. House and Lawrence Fisher and Paul B. PencharzDOI: 10.1016/j.ab.2007.07.0262007

The branched-chain amino acid requirement of parenterally fed neonatal piglets is less than the enteral requirement.Elango R and Pencharz PB and Ball ROPubMed: 1236840510/2002

Research

Determination of the optimal amounts of protein and amino acids to be added to medical foods in children with in-born errors of metabolism, including Phenylketonuria, Methylmalonic acidemia/Propionic acidemiaChildren who are born with deficiency of an enzyme, have a block in metabolic pathways and causes toxic increases of some metabolites. Phenylketonuria (PKU) is an autosomal recessive disorder caused by deficiency of the enzyme phenylalanine hydroxylase (PAH). PAH deficiency leads to increased levels of phenylalanine (an amino acid) in plasma. Similarly, Methylmalonic Acidemia (MMA) and Propionic Acidemia (PA) involves children born with a defect in conversion of Methylmalonyl-CoA to Succinyl-CoA, which are formed from the metabolism of amino acids - methionine, threonine, isoleucine and valine. Treatment involves dietary restriction of these amino acids, with provision of added protein from specially formulated medical foods. We are exploring what amounts of protein and other amino acids are adequate for these vulnerable children to support growth, using minimally-invasive stable isotope based methods.

Assessment of the protein quality of foodsWhile the amount of protein we eat needs to be optimal, dietary recommendations for protein are based on food sources. But food sources vary in their indispensable and dispensable amino acid content, with some foods quite rich and balanced, while some have a few key indispensable amino acids as too low. In addition, during digestion there is some loss of these amino acids, and will result in less amino acids available for growth and development in children. Thus, we are conducting experiments to explore how amino acids from various food sources are ‘metabolically available’ for protein synthesis in young children using state-of-the-art stable isotope based methods.

Determination of protein and amino acid requirements during pregnancy and lactation It is important that pregnant women eat an adequate amount and quality of protein to ensure healthy growth and development of the fetus. It is well known that pregnant women need more high quality protein in their diet, but how much additional protein is required remains unclear. There is reason to believe that current Dietary Reference Intake (DRI) recommendations for protein intake in pregnancy are too low. Additionally, metabolic adaptations that occur in a woman’s body throughout pregnancy result in different nutritional requirements during the 1st, 2nd, and 3rd trimesters. To better define protein and amino acid requirements and identify good sources of protein throughout pregnancy, we are studying healthy pregnant women 19-35y, in their 2nd and 3rd trimester of pregnancy using a stable isotope (L-1-13C-Phenylalanine) based technique.

Honours & Awards

Food and Agricultural Organization (FAO) of the United Nations, Expert Working Group Member, 2017

Food and Agricultural Organization (FAO) of the United Nations, Expert Working Group Member, 2014

Congratulations to the BC Children's and BC Women's investigators who were awarded funding from the Canadian Institutes of Health Research (CIHR) Project Grant Spring 2018 competition, as well as the BC Children's investigators who received funding from the recent CIHR Foundation and Team Grant competitions.

CFRI investigator Dr. Rajavel Elango was one of 10 international nutrition experts invited to take part in a Food and Agricultural Organization of the United Nations (FAO) Working Group to identify the best methods for measuring protein quality in human foods.

Dr. Bahaa Abu Raya has been awarded a Vanier Canada Graduate Scholarship (CGS) for his research into whooping cough immunization in pregnancy that helped change Canada’s national immunization guidelines on when expectant mothers should get a booster shot.

On March 11, 2019, BC Children’s Hospital Research Institute hosted the Canadian Institutes of Health Research for the announcement of $1.7-million in funding for early career investigators conducting high impact research in maternal, reproductive, child and youth health.

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